1. Field of the Invention
The invention generally relates to the field of medical education, and more particularly to the provision of information, via simulation, to a prospective surgical patient, who is faced with surgery to repair an inguinal hernia, so that the patient is in a position to make an informed consent to the proposed surgical procedure.
2. Prior Art
A hernia is an abnormal protrusion of an organ, tissue, or any anatomical structure through a forced opening in some part of the surrounding abdominal muscle wall. For example, if a part of the intestine were to protrude through the surrounding abdominal wall, it would create a hernia--an abdominal hernia.
Hernias occur in both males and females in the groin area, also called the inguinal region. In both sexes, the abdominal wall may be weak on both right and left sides a little above the crease in the groin. Hernias are found most frequently in males where the potential for weakness originates during the development of the fetus when the testicles are located inside the abdomen. Just prior to birth, the testicles "descend" and leave the abdomen and enter the scrotum, the sac that contains the testicles. In doing so, they push their way through the lower portion of the abdominal wall. Although the abdominal wall "closes" around the spermatic cord to which the testicle is attached after the testicles descend, the area remains slightly weakened throughout adult life. If a part of the intestines or other tissue within the abdominal cavity pushes through one of the weak spots, it forms a hernia--an inguinal hernia.
Before the piece of intestine or other abdominal cavity tissue, called the hernial mass, makes its way through the weak spot in the muscle, it must first push its way through the peritoneum, the membrane that lines the abdomen. The hernial mass does not tear the peritoneum, however. Thus, when the intestine protrudes, it merely takes the peritoneum with it and is covered by it. The peritoneal covering surrounding the piece of protruding intestine is called a hernial sac.
Inguinal hernias can be indirect or direct. An indirect inguinal hernia occurs in the following manner. The lower part of the abdominal wall where such hernias occur, the inguinal region, is comprised of several layers. A defect lateral to the epigastric vessels is an indirect hernia. A defect medial to the epigastric vessels is a direct hernia. A patient may have one or both of these defects. In starting to form the hernia, the hernial mass begins protruding through the internal ring adjacent to the spermatic cord and lateral to the epigastric vessels. When the hernial mass stretches out or pushes through weakened muscle wall located medial to the epigastric vessels, it is called a direct inguinal hernia.
Femoral hernias occur when intra-abdominal organs protrude into the femoral canal through a large femoral ring. Various factors contribute to an enlarged femoral ring, including the medial insertion of the iliopubic tract into the Cooper's ligament, creating a large femoral canal. A femoral hernia is sometimes easy to recognize because it always is located below the inguinal ligament and medial to the femoral vessels. All of the above hernias may reoccur. As a result, subsequent surgery, at the same location, will be altered by previous surgery and new anatomical arrangements.
Prospective surgical patients must be provided with adequate, easily understandable information regarding any surgical procedure, prior to the surgery, in order to grant their "informed consent" to the procedure. Patients must be apprised of traditional anterior abdominal surgical approaches, as well as, laparoscopic methods. Also, the inclusion of prosthetic meshes, and the like, as a part of the surgical repair must be accurately and effectively described to the patient. Physicians have had few options to turn to for support in their efforts to provide a patient with easily understood explanations of these complex (at least to the patient) surgical procedures.
As a result, there is a need in the art to provide a simple, relatively low cost, and easily understood device for explaining inguinal hernia repair surgery to the prospective surgical patient.